ClubCollect

Personal Details

Register for Break4U + Youth Fund. Enter your participant's information here. Below, explain why you're applying for the Youth Fund. The more compelling and engaging your story, the greater the chance of approval. NOTE: There is no guarantee that the Youth Fund will cover your tuition.

First Name (required)

Infix

Last Name (required)

Gender (required)

Male

Female

Rather not say

Date of Birth (required)

Contact Details

Contact Email (required)

Phone 1

Country Code (required)

Phone Number

Address line 1 (required)

House No. *

Extension

Postcode (required)

City (required)

Country

Information for the Youth Fund

Type of Membership (Subscription/Plan) (required)

Pass number

Which class do you want to take?(required)

Financial situation of parent(s)/guardian(s)(required)

Insufficient income

Government benefit

Debts

Other

Do you use a city pass? (Like U-pas)(required)

Yes

Explanation of your financial situation. Explain why you cannot afford the lessons. The more detailed your explanation and better your story, the greater the chance that the Youth Fund will approve your application.(required)

Additional Info

I agree to the General Terms and Conditions.